Stroke presentation 2 poster complete

Hariison and archit bollor bassed

Reading File

I'll create a comprehensive stroke presentation poster based on Harrison's and Andreoli/Bollor (likely referring to Andreoli and Carpenter's Cecil Essentials or similar). Let me search the medical library for stroke content.

Finding Sources

Now let me read the key sections from Harrison's on Stroke Syndromes and the Goldman-Cecil content:

Reading File

I now have excellent content. Let me fetch the key anatomical diagrams and then create the poster.

Loading Image

Excellent! I now have all the diagrams and content needed. Let me read the posterior circulation stroke content from Harrison's to complete the poster.

Reading File

I now have comprehensive content from Harrison's. Let me now build the complete poster using the PPTX skill for a professional medical poster.

Reading File

Now let me create the comprehensive stroke presentation poster as a PPTX file:

Running Command

mkdir -p /home/daytona/workspace/stroke-poster && ls /home/daytona/workspace/stroke-poster/

Hariison and archit bollor bassed stroke prentaton 1 page poster prepareHariison and archit bollor bassed stroke prentaton 1 page poster prepare

Now I'll build the complete 1-page poster. I have all the Harrison's content and images from the previous session ready to use.

Writing File

~/stroke-poster/make_poster.js

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// Fetch brain anatomy images
const imageUrls = [
  "https://cdn.orris.care/cdss_images/a94f73b585c5e20ed028f1355e098e6586f719d44ecf40e25bcecae9becae90e.png",  // coronal - vascular territories
  "https://cdn.orris.care/cdss_images/8f0e604f6f7bf69fead85d715302de646237f0d46b91557eecf6337566990d8d.png",  // lateral MCA
  "https://cdn.orris.care/cdss_images/697e750632ff92a3b9dd4b7dd47a61a2a44176ffc37a7f4c30e64d9224280140.png",  // medial ACA/PCA
];

console.log("Fetching images...");
const images = JSON.parse(
  execSync(
    `node /home/daytona/skills/shared/scripts/fetch_images.js "${imageUrls[0]}" "${imageUrls[1]}" "${imageUrls[2]}"`
  ).toString()
);
console.log("Images fetched:", images.map(i => i.error || "OK"));

// ─── POSTER SETUP ────────────────────────────────────────────────────────────
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3" × 7.5"
pres.title = "Stroke Presentation Poster";

const W = 13.3;
const H = 7.5;

// Color palette - deep medical navy dominant, crimson accent
const C = {
  navy:       "0D2B5E",   // dominant background panels
  navyDark:   "081A40",   // header/footer
  crimson:    "C0272D",   // accent headers
  gold:       "E8A020",   // subaccent
  steel:      "2F5F8F",   // mid panels
  white:      "FFFFFF",
  offwhite:   "F2F5FA",
  lightblue:  "D6E4F0",
  textDark:   "0D2B5E",
  textLight:  "FFFFFF",
  textGray:   "445566",
  green:      "1A7A4A",
  orange:     "D15400",
};

const slide = pres.addSlide();

// ═══════════════════════════════════════════════════════════════
// BACKGROUND
// ═══════════════════════════════════════════════════════════════
slide.addShape(pres.shapes.RECTANGLE, {
  x: 0, y: 0, w: W, h: H,
  fill: { color: C.offwhite }, line: { color: C.offwhite }
});

// ═══════════════════════════════════════════════════════════════
// HEADER BAR
// ═══════════════════════════════════════════════════════════════
slide.addShape(pres.shapes.RECTANGLE, {
  x: 0, y: 0, w: W, h: 0.72,
  fill: { color: C.navyDark }, line: { color: C.navyDark }
});
// Crimson left accent stripe
slide.addShape(pres.shapes.RECTANGLE, {
  x: 0, y: 0, w: 0.18, h: 0.72,
  fill: { color: C.crimson }, line: { color: C.crimson }
});

slide.addText("STROKE  ·  CLINICAL PRESENTATION & SYNDROMES", {
  x: 0.25, y: 0, w: 9.5, h: 0.72,
  fontSize: 22, bold: true, color: C.white, fontFace: "Calibri",
  align: "left", valign: "middle", margin: 0
});
slide.addText("Based on Harrison's Principles of Internal Medicine 22e  &  Goldman-Cecil Medicine", {
  x: 0.25, y: 0, w: 13, h: 0.72,
  fontSize: 9, color: "B0C4DE", fontFace: "Calibri",
  align: "right", valign: "bottom", margin: 4
});

// ═══════════════════════════════════════════════════════════════
// SECTION HEADER HELPER
// ═══════════════════════════════════════════════════════════════
function sectionHeader(slide, x, y, w, label, color) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x, y, w, h: 0.26,
    fill: { color: color || C.crimson }, line: { color: color || C.crimson }
  });
  slide.addText(label, {
    x: x + 0.06, y, w: w - 0.06, h: 0.26,
    fontSize: 8.5, bold: true, color: C.white, fontFace: "Calibri",
    align: "left", valign: "middle", margin: 0, charSpacing: 1.5
  });
}

function panel(slide, x, y, w, h, fillColor) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x, y, w, h,
    fill: { color: fillColor || C.white },
    line: { color: "CBD8E8", pt: 0.5 },
    shadow: { type: "outer", color: "000000", blur: 4, offset: 1, angle: 135, opacity: 0.08 }
  });
}

// ═══════════════════════════════════════════════════════════════
// ROW 1  (y=0.82 to 2.60) — 3 columns
// ═══════════════════════════════════════════════════════════════
const row1y = 0.82;
const row1h = 1.78;
const col1x = 0.12, col2x = 4.52, col3x = 8.92;
const colW = 4.22;

// ── COL 1: DEFINITION & CLASSIFICATION ──────────────────────────
panel(slide, col1x, row1y, colW, row1h);
sectionHeader(slide, col1x, row1y, colW, "DEFINITION & CLASSIFICATION");
slide.addText([
  { text: "Stroke: ", options: { bold: true, color: C.textDark } },
  { text: "Sudden neurological deficit lasting >24h (or any duration with infarction on imaging) due to focal cerebrovascular pathology.\n", options: { color: C.textGray } },
  { text: "\nIschemic (87%)\n", options: { bold: true, color: C.steel } },
  { text: "• Large-vessel atherothrombosis  (~30%)\n• Cardioembolic (A-fib, LV thrombus)  (~25%)\n• Small-vessel (lacunar)  (~20%)\n• Cryptogenic / undetermined  (~20%)\n• Other (dissection, vasculitis, hypercoag)  (~5%)\n", options: { color: C.textGray } },
  { text: "\nHemorrhagic (13%)\n", options: { bold: true, color: C.crimson } },
  { text: "• Intracerebral hemorrhage (ICH)\n• Subarachnoid hemorrhage (SAH)", options: { color: C.textGray } },
], {
  x: col1x + 0.1, y: row1y + 0.3, w: colW - 0.2, h: row1h - 0.36,
  fontSize: 7.8, fontFace: "Calibri", valign: "top"
});

// ── COL 2: FAST + TIA ──────────────────────────────────────────
panel(slide, col2x, row1y, colW, row1h);
sectionHeader(slide, col2x, row1y, colW, "RECOGNITION: FAST & TIA", C.crimson);
// FAST boxes
const fastItems = [
  { letter: "F", word: "Face", detail: "Facial droop / asymmetry", col: "C0272D" },
  { letter: "A", word: "Arm", detail: "Arm weakness / drift", col: "1A4F8A" },
  { letter: "S", word: "Speech", detail: "Slurred / absent speech", col: "1A7A4A" },
  { letter: "T", word: "Time", detail: "Call 999/112 immediately!", col: "D15400" },
];
fastItems.forEach((item, i) => {
  const bx = col2x + 0.1 + i * 1.0;
  const by = row1y + 0.32;
  slide.addShape(pres.shapes.RECTANGLE, { x: bx, y: by, w: 0.92, h: 0.58, fill: { color: item.col }, line: { color: item.col } });
  slide.addText(item.letter, { x: bx, y: by, w: 0.92, h: 0.38, fontSize: 20, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
  slide.addText(item.word, { x: bx, y: by + 0.38, w: 0.92, h: 0.20, fontSize: 7, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
  slide.addText(item.detail, { x: bx, y: by + 0.60, w: 0.92, h: 0.28, fontSize: 6.5, color: C.textGray, fontFace: "Calibri", align: "center", valign: "top" });
});
slide.addText([
  { text: "TIA: ", options: { bold: true, color: C.steel } },
  { text: "Same symptoms resolving <24h, no infarction on DWI. High early stroke risk (ABCD² score).\n", options: { color: C.textGray } },
  { text: "\nOther warning signs: ", options: { bold: true, color: C.textDark } },
  { text: "Sudden severe headache ('thunderclap'), unilateral vision loss (amaurosis fugax), diplopia, ataxia, vertigo with vomiting, sudden confusion.", options: { color: C.textGray } },
], {
  x: col2x + 0.1, y: row1y + 1.08, w: colW - 0.2, h: 0.68,
  fontSize: 7.5, fontFace: "Calibri", valign: "top"
});

// ── COL 3: RISK FACTORS & ABCD2 ─────────────────────────────────
panel(slide, col3x, row1y, colW, row1h);
sectionHeader(slide, col3x, row1y, colW, "RISK FACTORS & ABCD² SCORE", C.steel);
slide.addText([
  { text: "Modifiable risk factors:\n", options: { bold: true, color: C.steel } },
  { text: "Hypertension (#1) • Atrial fibrillation • Smoking • Diabetes mellitus • Hyperlipidemia • Carotid stenosis • Heart failure • Obesity • Physical inactivity\n", options: { color: C.textGray } },
  { text: "\nABCD² Score (TIA stroke risk at 2 days)\n", options: { bold: true, color: C.crimson } },
], {
  x: col3x + 0.1, y: row1y + 0.30, w: colW - 0.2, h: 0.72,
  fontSize: 7.5, fontFace: "Calibri", valign: "top"
});
// ABCD2 mini table
const abcdRows = [
  ["Age ≥60 yrs", "1"],
  ["BP ≥140/90", "1"],
  ["Clinical features: unilateral weakness", "2"],
  ["Speech disturbance only", "1"],
  ["Duration ≥60 min", "2 | 10-59 min = 1"],
  ["Diabetes", "1"],
];
abcdRows.forEach((row, i) => {
  const ty = row1y + 1.04 + i * 0.115;
  slide.addShape(pres.shapes.RECTANGLE, { x: col3x + 0.1, y: ty, w: 3.3, h: 0.11, fill: { color: i % 2 === 0 ? "E8F0FA" : C.white }, line: { color: C.offwhite } });
  slide.addText(row[0], { x: col3x + 0.12, y: ty, w: 2.6, h: 0.11, fontSize: 6.8, color: C.textGray, fontFace: "Calibri", valign: "middle" });
  slide.addText(row[1], { x: col3x + 2.72, y: ty, w: 0.7, h: 0.11, fontSize: 6.8, bold: true, color: C.navy, fontFace: "Calibri", align: "center", valign: "middle" });
});
slide.addText("Score 0-3: Low risk  |  4-5: Moderate  |  6-7: High", {
  x: col3x + 0.1, y: row1y + 1.73, w: colW - 0.2, h: 0.12,
  fontSize: 6.8, italic: true, color: C.steel, fontFace: "Calibri"
});

// ═══════════════════════════════════════════════════════════════
// ROW 2 — VASCULAR ANATOMY DIAGRAMS (center) + syndromes left/right
// ═══════════════════════════════════════════════════════════════
const row2y = 2.68;
const row2h = 2.52;

// ── LEFT: ANTERIOR CIRCULATION SYNDROMES ────────────────────────
panel(slide, col1x, row2y, 4.25, row2h);
sectionHeader(slide, col1x, row2y, 4.25, "ANTERIOR CIRCULATION STROKES");

slide.addText([
  { text: "MCA (Middle Cerebral Artery) — Most common\n", options: { bold: true, color: C.steel } },
  { text: "Full occlusion: ", options: { bold: true, color: C.textDark } },
  { text: "Contralateral hemiplegia, hemianesthesia, homonymous hemianopia, ipsilateral gaze deviation, dysarthria\n", options: { color: C.textGray } },
  { text: "Dominant (L) hemisphere: ", options: { bold: true, color: C.textDark } },
  { text: "Global aphasia\n", options: { color: C.textGray } },
  { text: "Non-dominant (R) hemisphere: ", options: { bold: true, color: C.textDark } },
  { text: "Anosognosia, hemispatial neglect, constructional apraxia\n", options: { color: C.textGray } },
  { text: "Superior division: ", options: { bold: true, color: C.textDark } },
  { text: "Broca's (non-fluent) aphasia + contralateral face/arm > leg weakness\n", options: { color: C.textGray } },
  { text: "Inferior division: ", options: { bold: true, color: C.textDark } },
  { text: "Wernicke's (fluent) aphasia + superior quadrantanopia\n", options: { color: C.textGray } },
  { text: "Lacunar (lenticulostriate): ", options: { bold: true, color: C.textDark } },
  { text: "Pure motor/sensory stroke; clumsy hand + dysarthria\n\n", options: { color: C.textGray } },

  { text: "ACA (Anterior Cerebral Artery)\n", options: { bold: true, color: C.steel } },
  { text: "Contralateral leg > arm weakness, cortical sensory loss (foot/leg), urinary incontinence, gait apraxia, abulia (bilateral: paraparesis + mutism)\n\n", options: { color: C.textGray } },

  { text: "Internal Carotid Artery (ICA)\n", options: { bold: true, color: C.steel } },
  { text: "Amaurosis fugax (ipsilateral monocular blindness), MCA + ACA territory deficit, Horner's syndrome (if cervical)", options: { color: C.textGray } },
], {
  x: col1x + 0.1, y: row2y + 0.30, w: 4.05, h: row2h - 0.36,
  fontSize: 7.4, fontFace: "Calibri", valign: "top"
});

// ── CENTER: BRAIN DIAGRAMS ──────────────────────────────────────
const imgX = 4.50;
const imgW = 4.25;
if (images[0] && !images[0].error) {
  slide.addImage({ data: images[0].base64, x: imgX, y: row2y + 0.28, w: 2.0, h: 1.55 });
}
if (images[1] && !images[1].error) {
  slide.addImage({ data: images[1].base64, x: imgX + 2.1, y: row2y + 0.28, w: 2.1, h: 1.55 });
}
if (images[2] && !images[2].error) {
  slide.addImage({ data: images[2].base64, x: imgX + 0.55, y: row2y + 1.90, w: 3.1, h: 1.30 });
}
// Image captions
slide.addText("Coronal vascular territories", { x: imgX, y: row2y + 1.83, w: 2.1, h: 0.14, fontSize: 5.8, italic: true, color: C.textGray, fontFace: "Calibri", align: "center" });
slide.addText("Lateral MCA branches", { x: imgX + 2.1, y: row2y + 1.83, w: 2.1, h: 0.14, fontSize: 5.8, italic: true, color: C.textGray, fontFace: "Calibri", align: "center" });
slide.addText("Medial ACA / PCA distribution", { x: imgX + 0.4, y: row2y + 3.18, w: 3.4, h: 0.14, fontSize: 5.8, italic: true, color: C.textGray, fontFace: "Calibri", align: "center" });
slide.addText("Source: Harrison's Principles of Internal Medicine, 22e", {
  x: imgX + 0.1, y: row2y + 3.34, w: 4.0, h: 0.14,
  fontSize: 5.5, italic: true, color: "8899AA", fontFace: "Calibri", align: "center"
});

// ── RIGHT: POSTERIOR CIRCULATION SYNDROMES ──────────────────────
panel(slide, 8.9, row2y, 4.25, row2h);
sectionHeader(slide, 8.9, row2y, 4.25, "POSTERIOR CIRCULATION STROKES", C.navy);

slide.addText([
  { text: "PCA (Posterior Cerebral Artery)\n", options: { bold: true, color: C.steel } },
  { text: "P1 (proximal) syndrome: ", options: { bold: true, color: C.textDark } },
  { text: "3rd nerve palsy + contralateral ataxia (Claude's) or hemiplegia (Weber's); thalamic signs (amnesia, confusion), midbrain ischemia\n", options: { color: C.textGray } },
  { text: "P2 (cortical) syndrome: ", options: { bold: true, color: C.textDark } },
  { text: "Homonymous hemianopia (macular sparing), cortical blindness (bilateral), alexia without agraphia, prosopagnosia, memory impairment\n\n", options: { color: C.textGray } },

  { text: "Basilar Artery — EMERGENCY\n", options: { bold: true, color: C.crimson } },
  { text: "Top-of-basilar: ", options: { bold: true, color: C.textDark } },
  { text: "Bilateral motor + sensory deficits, coma, 'locked-in syndrome'\n", options: { color: C.textGray } },
  { text: "Warning: ", options: { bold: true, color: C.textDark } },
  { text: "Multiple TIAs in brainstem territory (diplopia, ataxia, perioral numbness, drop attacks)\n\n", options: { color: C.textGray } },

  { text: "Vertebral Artery / PICA\n", options: { bold: true, color: C.steel } },
  { text: "Lateral medullary (Wallenberg) syndrome: ", options: { bold: true, color: C.textDark } },
  { text: "Ipsilateral: facial pain/numbness, Horner's, ataxia, hoarseness\nContralateral: pain/temp loss body\nDysphagia, vertigo, nystagmus, hiccups\n\n", options: { color: C.textGray } },

  { text: "Lacunar Syndromes (small-vessel)\n", options: { bold: true, color: C.steel } },
  { text: "Pure motor hemiplegia (post. limb internal capsule) • Pure sensory stroke (thalamus VPL) • Ataxic hemiparesis • Clumsy hand–dysarthria • Sensorimotor stroke", options: { color: C.textGray } },
], {
  x: 9.0, y: row2y + 0.30, w: 4.05, h: row2h - 0.36,
  fontSize: 7.4, fontFace: "Calibri", valign: "top"
});

// ═══════════════════════════════════════════════════════════════
// ROW 3 — MANAGEMENT (3 panels across bottom)
// ═══════════════════════════════════════════════════════════════
const row3y = 5.28;
const row3h = 1.78;
const mgmtW = 4.22;

// ── ACUTE MANAGEMENT ─────────────────────────────────────────────
panel(slide, col1x, row3y, mgmtW, row3h);
sectionHeader(slide, col1x, row3y, mgmtW, "ACUTE MANAGEMENT (ISCHEMIC)", C.crimson);
slide.addText([
  { text: "Time targets:", options: { bold: true, color: C.steel } },
  { text: "  Door-to-CT ≤25 min  |  Door-to-needle (tPA) ≤60 min  |  Onset-to-needle ≤4.5 h\n", options: { color: C.textGray } },
  { text: "\nIV Alteplase (tPA): ", options: { bold: true, color: C.textDark } },
  { text: "0.9 mg/kg (max 90 mg), 10% bolus + 60 min infusion. Window: ≤4.5 h from onset. Contraindications: ICH, recent surgery, uncontrolled BP >185/110, coagulopathy\n", options: { color: C.textGray } },
  { text: "\nEndovascular thrombectomy (EVT): ", options: { bold: true, color: C.textDark } },
  { text: "Large-vessel occlusion, up to 24 h with perfusion imaging selection (DAWN/DEFUSE-3). Treat BP <185/110 before tPA\n", options: { color: C.textGray } },
  { text: "\nGeneral care: ", options: { bold: true, color: C.textDark } },
  { text: "O₂ only if SpO₂ <94%. Avoid glucose >180 mg/dL. Permissive hypertension (allow up to 220/120 if no tPA). Antipyretics if febrile. DVT prophylaxis.", options: { color: C.textGray } },
], {
  x: col1x + 0.1, y: row3y + 0.30, w: mgmtW - 0.2, h: row3h - 0.36,
  fontSize: 7.3, fontFace: "Calibri", valign: "top"
});

// ── INVESTIGATIONS ──────────────────────────────────────────────
panel(slide, col2x, row3y, mgmtW, row3h);
sectionHeader(slide, col2x, row3y, mgmtW, "KEY INVESTIGATIONS", C.steel);
slide.addText([
  { text: "IMMEDIATE (all patients):\n", options: { bold: true, color: C.steel } },
  { text: "• NCCT brain — exclude hemorrhage (do NOT delay for MRI)\n• ECG — AF, acute MI\n• Blood: glucose, FBC, coagulation, U&E, troponin, lipids\n• CXR, SpO₂\n\n", options: { color: C.textGray } },
  { text: "IMAGING for reperfusion decisions:\n", options: { bold: true, color: C.steel } },
  { text: "• CT angiography (CTA) — large vessel occlusion, carotid stenosis\n• CT perfusion — ischemic penumbra (salvageable tissue)\n• MRI DWI/PWI — gold standard; confirms TIA vs stroke\n\n", options: { color: C.textGray } },
  { text: "ETIOLOGY WORKUP (admit):\n", options: { bold: true, color: C.steel } },
  { text: "• Cardiac monitoring ≥24h (prolonged telemetry/Holter for AF)\n• Echocardiography — source of emboli\n• Carotid Doppler / CTA neck\n• Hypercoagulable screen if young stroke", options: { color: C.textGray } },
], {
  x: col2x + 0.1, y: row3y + 0.30, w: mgmtW - 0.2, h: row3h - 0.36,
  fontSize: 7.3, fontFace: "Calibri", valign: "top"
});

// ── SECONDARY PREVENTION ─────────────────────────────────────────
panel(slide, col3x, row3y, mgmtW, row3h);
sectionHeader(slide, col3x, row3y, mgmtW, "SECONDARY PREVENTION & PROGNOSIS", C.navy);
slide.addText([
  { text: "Antiplatelet (non-cardioembolic):\n", options: { bold: true, color: C.steel } },
  { text: "Aspirin 300 mg STAT → dual (aspirin + clopidogrel) for 21 days (POINT/CHANCE), then clopidogrel 75 mg monotherapy\n\n", options: { color: C.textGray } },
  { text: "Anticoagulation (cardioembolic / AF):\n", options: { bold: true, color: C.steel } },
  { text: "DOAC (rivaroxaban / apixaban) preferred over warfarin. Start 4-14 days post-stroke depending on infarct size\n\n", options: { color: C.textGray } },
  { text: "Risk factor control:\n", options: { bold: true, color: C.steel } },
  { text: "BP target <130/80 mmHg • Statin (LDL-C <1.8 mmol/L) • HbA1c control • Smoking cessation • Carotid endarterectomy if stenosis 70-99% (symptomatic)\n\n", options: { color: C.textGray } },
  { text: "Prognosis:", options: { bold: true, color: C.crimson } },
  { text: "  ~1/3 recover fully  |  ~1/3 moderate disability  |  ~1/3 severe or death. NIHSS score guides prognosis. Stroke Unit care reduces mortality by ~25%.", options: { color: C.textGray } },
], {
  x: col3x + 0.1, y: row3y + 0.30, w: mgmtW - 0.2, h: row3h - 0.36,
  fontSize: 7.3, fontFace: "Calibri", valign: "top"
});

// ═══════════════════════════════════════════════════════════════
// FOOTER
// ═══════════════════════════════════════════════════════════════
slide.addShape(pres.shapes.RECTANGLE, {
  x: 0, y: H - 0.22, w: W, h: 0.22,
  fill: { color: C.navyDark }, line: { color: C.navyDark }
});
slide.addShape(pres.shapes.RECTANGLE, {
  x: 0, y: H - 0.22, w: 0.18, h: 0.22,
  fill: { color: C.gold }, line: { color: C.gold }
});
slide.addText(
  "Harrison's Principles of Internal Medicine, 22e (2025)  ·  Goldman-Cecil Medicine, International Ed  ·  Bradley & Daroff's Neurology in Clinical Practice  ·  Adams & Victor's Principles of Neurology, 12e",
  {
    x: 0.24, y: H - 0.22, w: 12.8, h: 0.22,
    fontSize: 5.5, color: "8899BB", fontFace: "Calibri",
    align: "left", valign: "middle", margin: 0
  }
);

// ═══════════════════════════════════════════════════════════════
// DIVIDER LINES between major sections
// ═══════════════════════════════════════════════════════════════
// Horizontal dividers
[row2y - 0.04, row3y - 0.04].forEach(dy => {
  slide.addShape(pres.shapes.LINE, {
    x: 0.12, y: dy, w: W - 0.24, h: 0,
    line: { color: "CBD8E8", pt: 0.5 }
  });
});

const outPath = "/home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("Poster saved:", outPath);
});

Running Command

cd /home/daytona/workspace/stroke-poster && node make_poster.js 2>&1

The buffer overflow is from 3 large images in one call. I'll fetch each image separately and save to files first, then use file paths.

Running Command

cd /home/daytona/workspace/stroke-poster && \ node /home/daytona/skills/shared/scripts/fetch_images.js "https://cdn.orris.care/cdss_images/a94f73b585c5e20ed028f1355e098e6586f719d44ecf40e25bcecae9becae90e.png" > img1.json && echo "img1 done" && \ node /home/daytona/skills/shared/scripts/fetch_images.js "https://cdn.orris.care/cdss_images/8f0e604f6f7bf69fead85d715302de646237f0d46b91557eecf6337566990d8d.png" > img2.json && echo "img2 done" && \ node /home/daytona/skills/shared/scripts/fetch_images.js "https://cdn.orris.care/cdss_images/697e750632ff92a3b9dd4b7dd47a61a2a44176ffc37a7f4c30e64d9224280140.png" > img3.json && echo "img3 done"

Now update the script to load from JSON files instead of execSync:

Editing File

~/stroke-poster/make_poster.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/stroke-poster/make_poster.js'

Also remove the unused execSync import line:

Editing File

~/stroke-poster/make_poster.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/stroke-poster/make_poster.js'

Running Command

cd /home/daytona/workspace/stroke-poster && node make_poster.js 2>&1

Let me verify the file size looks right and generate a thumbnail preview:

Running Command

ls -lh /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx && node /home/daytona/skills/pptx/scripts/thumbnail.py /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx 2>/dev/null || python3 /home/daytona/skills/pptx/scripts/thumbnail.py /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx 2>&1 | head -20

Loading Image

Running Command

ls /home/daytona/workspace/stroke-poster/ && find /home/daytona/workspace/stroke-poster -name "thumbnails*" 2>/dev/null

The PPTX is built successfully (1.4 MB). The thumbnail script ran but saved to the current directory. The poster is ready.Your 1-page stroke presentation poster is ready:

Stroke Presentation Poster

Presentation · PPTX

What's on the poster (based on Harrison's 22e & Goldman-Cecil Medicine):

The poster is laid out in a 3-column, 3-row grid on a wide-format slide (13.3" × 7.5") with a dark navy/crimson medical color scheme:

Top row:

Definition & Classification (ischemic 87% vs hemorrhagic 13%, subtypes)
FAST recognition + TIA definition with color-coded F-A-S-T boxes
Risk factors + ABCD² scoring table

Middle row (the main clinical content):

Anterior circulation syndromes: full MCA, superior/inferior MCA divisions, Broca's/Wernicke's aphasia, ACA (leg > arm, abulia), ICA (amaurosis fugax)
3 original Harrison's brain diagrams - coronal vascular territories, lateral MCA branches, medial ACA/PCA distribution
Posterior circulation syndromes: PCA (P1 Weber/Claude, P2 hemianopia), Basilar artery (locked-in syndrome), Wallenberg's lateral medullary syndrome, lacunar syndromes

Bottom row:

Acute management: tPA window (≤4.5h), dosing, EVT indications, BP targets, general care
Key investigations: CT, MRI DWI, CTA, cardiac monitoring, echocardiography
Secondary prevention: antiplatelet (POINT/CHANCE dual therapy), anticoagulation for AF (DOACs), BP/statin targets, carotid endarterectomy indications, prognosis

Make a PDF version of the poster for easier sharing

Converting the PPTX to PDF using LibreOffice now.

Running Command

libreoffice --headless --convert-to pdf --outdir /home/daytona/workspace/stroke-poster/ /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx 2>&1

Running Command

cp /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pptx /tmp/stroke_temp.pptx && libreoffice --headless --convert-to pdf --outdir /tmp/ /tmp/stroke_temp.pptx 2>&1 && cp /tmp/stroke_temp.pdf /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pdf && ls -lh /home/daytona/workspace/stroke-poster/Stroke_Presentation_Poster.pdf

Done. Here's your PDF:

Stroke Presentation Poster

PDF Document · PDF

233 KB - opens in any PDF viewer or browser. The PPTX is still available too if you ever want to edit it:

Stroke Presentation Poster

Presentation · PPTX

Instagram poster mode

Instagram format = 1:1 square (1080×1080px) — but one slide can't fit all that content legibly. I'll make a carousel series (10 square slides), one topic per card, optimized for mobile reading.

Running Command

ls /home/daytona/workspace/stroke-poster/img1.json 2>/dev/null && echo "Images already cached" || echo "Need to fetch"

Images are cached. Now build the full carousel:

Writing File

~/stroke-poster/make_instagram.js

const pptxgen = require("pptxgenjs");
const fs = require("fs");

// Load cached images
const img1 = JSON.parse(fs.readFileSync("/home/daytona/workspace/stroke-poster/img1.json"))[0]; // coronal territories
const img2 = JSON.parse(fs.readFileSync("/home/daytona/workspace/stroke-poster/img2.json"))[0]; // lateral MCA
const img3 = JSON.parse(fs.readFileSync("/home/daytona/workspace/stroke-poster/img3.json"))[0]; // medial ACA/PCA

// ── SETUP ─────────────────────────────────────────────────────────────────
const pres = new pptxgen();
// Instagram square = 1080×1080px → use custom layout in inches (1080/96 = 11.25")
pres.defineLayout({ name: "SQUARE", width: 7.5, height: 7.5 });
pres.layout = "SQUARE";

const W = 7.5;
const H = 7.5;

// Color palette — modern, bold, Instagram-optimized
const C = {
  navy:     "0B1F4B",
  navyMid:  "142B65",
  steel:    "1C4E8A",
  crimson:  "C0272D",
  gold:     "E8A020",
  teal:     "0D7377",
  purple:   "5B2D8E",
  green:    "1A7A4A",
  white:    "FFFFFF",
  offwhite: "F0F4FA",
  light:    "D6E4F7",
  gray:     "556677",
  darkgray: "334455",
  orange:   "D15400",
};

// ── HELPERS ───────────────────────────────────────────────────────────────
function bg(slide, color) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: W, h: H,
    fill: { color }, line: { color }
  });
}

function topBar(slide, color, text, sub) {
  // Top accent strip
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: W, h: 0.55,
    fill: { color }, line: { color }
  });
  slide.addText(text, {
    x: 0.25, y: 0, w: W - 0.5, h: 0.55,
    fontSize: 11, bold: true, color: C.white, fontFace: "Calibri",
    align: "center", valign: "middle", charSpacing: 1.5
  });
  if (sub) {
    slide.addText(sub, {
      x: 0.25, y: 0.55, w: W - 0.5, h: 0.28,
      fontSize: 8, color: color, fontFace: "Calibri",
      align: "center", valign: "middle", bold: true, charSpacing: 0.5
    });
  }
}

function bottomBar(slide, pageNum, total) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: H - 0.38, w: W, h: 0.38,
    fill: { color: C.navy }, line: { color: C.navy }
  });
  slide.addText("STROKE  ·  Harrison's 22e & Goldman-Cecil", {
    x: 0.25, y: H - 0.38, w: W - 1.0, h: 0.38,
    fontSize: 7, color: "7799BB", fontFace: "Calibri",
    align: "left", valign: "middle"
  });
  slide.addText(`${pageNum}/${total}`, {
    x: W - 0.7, y: H - 0.38, w: 0.5, h: 0.38,
    fontSize: 8.5, bold: true, color: C.gold, fontFace: "Calibri",
    align: "center", valign: "middle"
  });
  // progress dots
  const total2 = total;
  const dotW = 0.11; const dotGap = 0.05;
  const totalW = total2 * dotW + (total2 - 1) * dotGap;
  const startX = (W - totalW) / 2;
  for (let i = 0; i < total2; i++) {
    slide.addShape(pres.shapes.OVAL, {
      x: startX + i * (dotW + dotGap),
      y: H - 0.38 - 0.18,
      w: dotW, h: dotW,
      fill: { color: i + 1 === pageNum ? C.gold : "445566" },
      line: { color: i + 1 === pageNum ? C.gold : "445566" }
    });
  }
}

function sectionLabel(slide, x, y, w, label, color) {
  slide.addShape(pres.shapes.RECTANGLE, { x, y, w, h: 0.28, fill: { color }, line: { color } });
  slide.addShape(pres.shapes.RECTANGLE, { x, y, w: 0.06, h: 0.28, fill: { color: C.gold }, line: { color: C.gold } });
  slide.addText(label, {
    x: x + 0.1, y, w: w - 0.12, h: 0.28,
    fontSize: 9, bold: true, color: C.white, fontFace: "Calibri",
    charSpacing: 1, align: "left", valign: "middle"
  });
}

function card(slide, x, y, w, h, fill) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x, y, w, h,
    fill: { color: fill || C.white },
    line: { color: "C8D8EC", pt: 0.8 },
    shadow: { type: "outer", color: "000000", blur: 5, offset: 2, angle: 135, opacity: 0.1 }
  });
}

const TOTAL = 10;

// ════════════════════════════════════════════════════════════════════════
// SLIDE 1 — COVER
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.navy);

  // Bold diagonal accent shape
  s.addShape(pres.shapes.RECTANGLE, {
    x: -0.5, y: 4.8, w: 8.5, h: 3.5,
    fill: { color: C.crimson }, line: { color: C.crimson }, rotate: -8
  });
  s.addShape(pres.shapes.RECTANGLE, {
    x: -0.5, y: 5.3, w: 8.5, h: 3.5,
    fill: { color: "8B0000" }, line: { color: "8B0000" }, rotate: -8
  });

  s.addText("STROKE", {
    x: 0.3, y: 1.0, w: W - 0.6, h: 1.5,
    fontSize: 72, bold: true, color: C.white, fontFace: "Calibri",
    align: "center", valign: "middle"
  });
  s.addText("Clinical Presentation\n& Syndromes", {
    x: 0.3, y: 2.5, w: W - 0.6, h: 1.1,
    fontSize: 24, color: C.gold, fontFace: "Calibri",
    align: "center", valign: "middle", bold: false
  });

  s.addShape(pres.shapes.LINE, {
    x: 1.5, y: 3.68, w: W - 3.0, h: 0,
    line: { color: C.gold, pt: 1.5 }
  });

  s.addText("Based on Harrison's Principles\nof Internal Medicine 22e\n& Goldman-Cecil Medicine", {
    x: 0.3, y: 3.78, w: W - 0.6, h: 0.95,
    fontSize: 11, color: "99BBDD", fontFace: "Calibri",
    align: "center", valign: "middle"
  });

  s.addText("Swipe to learn →", {
    x: 0.3, y: 6.6, w: W - 0.6, h: 0.4,
    fontSize: 11, bold: true, color: C.gold, fontFace: "Calibri",
    align: "center", valign: "middle"
  });
  bottomBar(s, 1, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 2 — DEFINITION & CLASSIFICATION
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.navy, "WHAT IS A STROKE?", "Definition & Classification");

  // Big stat boxes
  const boxes = [
    { label: "87%", sub: "Ischemic", col: C.steel },
    { label: "13%", sub: "Hemorrhagic", col: C.crimson },
  ];
  boxes.forEach((b, i) => {
    const bx = 0.4 + i * 3.55;
    card(s, bx, 1.0, 3.25, 1.4, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: bx, y: 1.0, w: 3.25, h: 0.08, fill: { color: b.col }, line: { color: b.col } });
    s.addText(b.label, { x: bx, y: 1.05, w: 3.25, h: 0.85, fontSize: 44, bold: true, color: b.col, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(b.sub, { x: bx, y: 1.88, w: 3.25, h: 0.48, fontSize: 13, bold: true, color: b.col, fontFace: "Calibri", align: "center", valign: "middle" });
  });

  s.addText("Sudden focal neurological deficit due to\ncerebrovascular disease (infarct or bleed)", {
    x: 0.3, y: 2.5, w: W - 0.6, h: 0.65,
    fontSize: 13, color: C.darkgray, fontFace: "Calibri", align: "center", valign: "middle"
  });

  // Ischemic subtypes
  sectionLabel(s, 0.3, 3.22, W - 0.6, "ISCHEMIC SUBTYPES", C.steel);
  const iTypes = [
    ["Large-vessel atherothrombosis", "~30%"],
    ["Cardioembolic (AF, LV thrombus)", "~25%"],
    ["Small-vessel / Lacunar", "~20%"],
    ["Cryptogenic / Undetermined", "~20%"],
    ["Other (dissection, vasculitis)", " ~5%"],
  ];
  iTypes.forEach(([label, pct], i) => {
    const ry = 3.56 + i * 0.48;
    card(s, 0.3, ry, W - 0.6, 0.44, i % 2 === 0 ? "EBF2FB" : C.white);
    s.addText(label, { x: 0.42, y: ry, w: 4.9, h: 0.44, fontSize: 11, color: C.darkgray, fontFace: "Calibri", valign: "middle" });
    s.addText(pct, { x: 5.32, y: ry, w: 1.85, h: 0.44, fontSize: 12, bold: true, color: C.steel, fontFace: "Calibri", align: "right", valign: "middle" });
  });

  bottomBar(s, 2, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 3 — FAST + WARNING SIGNS
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.crimson, "RECOGNIZE STROKE FAST", "Time = Brain Cells");

  const fastItems = [
    { letter: "F", word: "Face", detail: "Facial droop\nor asymmetry", col: "C0272D" },
    { letter: "A", word: "Arm", detail: "Arm weakness\nor drift", col: "1C4E8A" },
    { letter: "S", word: "Speech", detail: "Slurred or\nabsent speech", col: "1A7A4A" },
    { letter: "T", word: "Time", detail: "Call Emergency\nIMMEDIATELY!", col: "D15400" },
  ];

  fastItems.forEach((item, i) => {
    const col = i % 2; const row = Math.floor(i / 2);
    const bx = 0.35 + col * 3.55;
    const by = 0.9 + row * 2.25;
    card(s, bx, by, 3.25, 2.1, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: bx, y: by, w: 3.25, h: 1.1, fill: { color: item.col }, line: { color: item.col } });
    s.addText(item.letter, { x: bx, y: by, w: 3.25, h: 1.1, fontSize: 56, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(item.word, { x: bx, y: by + 1.1, w: 3.25, h: 0.42, fontSize: 14, bold: true, color: item.col, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(item.detail, { x: bx, y: by + 1.52, w: 3.25, h: 0.54, fontSize: 10.5, color: C.gray, fontFace: "Calibri", align: "center", valign: "middle" });
  });

  s.addText("⏱  Every minute, ~1.9 million neurons die during a stroke", {
    x: 0.25, y: 5.45, w: W - 0.5, h: 0.42,
    fontSize: 10.5, bold: true, color: C.crimson, fontFace: "Calibri", align: "center", valign: "middle"
  });
  s.addText("TIA: Same symptoms but resolves <24h. Still URGENT — high early stroke risk!", {
    x: 0.25, y: 5.88, w: W - 0.5, h: 0.44,
    fontSize: 10, color: C.steel, fontFace: "Calibri", align: "center", valign: "middle",
    italic: true
  });

  bottomBar(s, 3, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 4 — RISK FACTORS
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.steel, "RISK FACTORS", "Modifiable & Non-Modifiable");

  sectionLabel(s, 0.3, 0.72, W - 0.6, "MODIFIABLE — TARGET THESE", C.crimson);
  const modRFs = [
    ["🩸", "Hypertension", "#1 modifiable risk factor"],
    ["💓", "Atrial Fibrillation", "5× stroke risk"],
    ["🚬", "Smoking", "2× stroke risk"],
    ["🍬", "Diabetes Mellitus", "1.5–3× risk"],
    ["🫀", "Hyperlipidaemia", "LDL drives atheroma"],
    ["⚖️", "Obesity & Inactivity", "Metabolic syndrome"],
    ["🍷", "Excess Alcohol", ">2 drinks/day"],
    ["💊", "OCP + Migraine", "Combined = high risk"],
  ];
  modRFs.forEach(([icon, label, note], i) => {
    const col = i % 2; const row = Math.floor(i / 2);
    const bx = 0.3 + col * 3.55;
    const by = 1.06 + row * 0.72;
    card(s, bx, by, 3.25, 0.65, col === 0 ? "EBF2FB" : C.white);
    s.addText(icon + "  " + label, { x: bx + 0.1, y: by, w: 2.5, h: 0.65, fontSize: 10.5, bold: true, color: C.navy, fontFace: "Calibri", valign: "middle" });
    s.addText(note, { x: bx + 0.1, y: by + 0.36, w: 3.0, h: 0.29, fontSize: 8.5, color: C.gray, fontFace: "Calibri", valign: "middle" });
  });

  sectionLabel(s, 0.3, 3.98, W - 0.6, "NON-MODIFIABLE", C.navy);
  s.addText("Age > 55  ·  Male sex  ·  Family history  ·  Prior stroke / TIA  ·  Sickle cell disease  ·  Race (African-Caribbean higher risk)", {
    x: 0.3, y: 4.3, w: W - 0.6, h: 0.65,
    fontSize: 10.5, color: C.darkgray, fontFace: "Calibri", align: "center", valign: "middle"
  });

  // ABCD2 mini
  sectionLabel(s, 0.3, 5.02, W - 0.6, "ABCD² SCORE — TIA 2-Day Stroke Risk", C.teal);
  const abcd = [["Age ≥60", "1"], ["BP ≥140/90", "1"], ["Clinical: unilateral weakness", "2"], ["Speech disturbance only", "1"], ["Duration ≥60 min / 10-59 min", "2 / 1"], ["Diabetes", "1"]];
  abcd.forEach(([item, pts], i) => {
    const ry = 5.35 + i * 0.29;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: ry, w: W - 0.6, h: 0.27, fill: { color: i % 2 === 0 ? "E8F0FA" : C.white }, line: { color: "DDEEFF" } });
    s.addText(item, { x: 0.42, y: ry, w: 5.4, h: 0.27, fontSize: 9.5, color: C.darkgray, fontFace: "Calibri", valign: "middle" });
    s.addText(pts, { x: 5.82, y: ry, w: 1.35, h: 0.27, fontSize: 10, bold: true, color: C.crimson, fontFace: "Calibri", align: "center", valign: "middle" });
  });
  s.addText("0-3 = Low  |  4-5 = Moderate  |  6-7 = HIGH RISK", {
    x: 0.3, y: 7.06, w: W - 0.6, h: 0.28,
    fontSize: 9, bold: true, color: C.teal, fontFace: "Calibri", align: "center"
  });

  bottomBar(s, 4, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 5 — VASCULAR ANATOMY
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.navy);
  topBar(s, C.crimson, "CEREBROVASCULAR ANATOMY", "Know the Territories");

  // Image 1 — coronal territories
  if (img1 && !img1.error) {
    s.addImage({ data: img1.base64, x: 0.25, y: 0.75, w: 3.4, h: 2.6 });
  }
  s.addText("Coronal — Vascular Territories", { x: 0.25, y: 3.35, w: 3.4, h: 0.3, fontSize: 8, italic: true, color: C.light, fontFace: "Calibri", align: "center" });

  // Image 2 — lateral MCA
  if (img2 && !img2.error) {
    s.addImage({ data: img2.base64, x: 3.85, y: 0.75, w: 3.4, h: 2.6 });
  }
  s.addText("Lateral — MCA Branches & Cortical Areas", { x: 3.85, y: 3.35, w: 3.4, h: 0.3, fontSize: 8, italic: true, color: C.light, fontFace: "Calibri", align: "center" });

  // Image 3 — medial
  if (img3 && !img3.error) {
    s.addImage({ data: img3.base64, x: 1.5, y: 3.72, w: 4.5, h: 3.08 });
  }
  s.addText("Medial — ACA & PCA Distribution", { x: 1.5, y: 6.78, w: 4.5, h: 0.28, fontSize: 8, italic: true, color: C.light, fontFace: "Calibri", align: "center" });

  s.addText("Harrison's Principles of Internal Medicine, 22e", {
    x: 0.2, y: 7.04, w: W - 0.4, h: 0.2,
    fontSize: 6.5, italic: true, color: "556688", fontFace: "Calibri", align: "center"
  });

  bottomBar(s, 5, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 6 — MCA STROKE SYNDROMES
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.steel, "MCA STROKE SYNDROMES", "Most Common — ~70% of Ischemic Strokes");

  const mcaItems = [
    {
      title: "Complete MCA Occlusion",
      col: C.steel,
      items: ["Contralateral hemiplegia (face + arm > leg)", "Hemianesthesia (sensory loss)", "Homonymous hemianopia", "Ipsilateral gaze deviation", "Dysarthria"]
    },
    {
      title: "Dominant (Left) Hemisphere",
      col: C.purple,
      items: ["Global aphasia (Broca + Wernicke)", "Superior div. → Broca's: non-fluent aphasia, face/arm weakness", "Inferior div. → Wernicke's: fluent aphasia, quadrantanopia"]
    },
    {
      title: "Non-Dominant (Right) Hemisphere",
      col: C.teal,
      items: ["Anosognosia (denial of deficit)", "Hemispatial neglect (left)", "Constructional apraxia", "Dressing apraxia, spatial disorientation"]
    },
    {
      title: "Lacunar / Lenticulostriate",
      col: C.orange,
      items: ["Pure motor hemiplegia (post. limb internal capsule)", "Clumsy hand + dysarthria syndrome", "Sensorimotor stroke"]
    },
  ];

  mcaItems.forEach((sec, i) => {
    const by = 0.82 + i * 1.6;
    card(s, 0.28, by, W - 0.56, 1.52, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: 0.28, y: by, w: 0.18, h: 1.52, fill: { color: sec.col }, line: { color: sec.col } });
    s.addText(sec.title, {
      x: 0.55, y: by + 0.04, w: W - 0.85, h: 0.32,
      fontSize: 11, bold: true, color: sec.col, fontFace: "Calibri", valign: "middle"
    });
    s.addText(sec.items.map(t => "• " + t).join("\n"), {
      x: 0.55, y: by + 0.36, w: W - 0.85, h: 1.1,
      fontSize: 9.5, color: C.darkgray, fontFace: "Calibri", valign: "top"
    });
  });

  bottomBar(s, 6, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 7 — ACA + PCA + ICA SYNDROMES
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.navy, "ACA · PCA · ICA SYNDROMES", "Anterior Circulation — Continued");

  const sections = [
    {
      title: "ACA — Anterior Cerebral Artery",
      col: C.green,
      items: [
        "Contralateral leg > arm weakness (medial cortex)",
        "Cortical sensory loss: foot & leg",
        "Urinary incontinence",
        "Gait apraxia (frontal lobe)",
        "Abulia: slowed responses, lack of spontaneity",
        "Bilateral A2 occlusion → paraparesis + mutism"
      ]
    },
    {
      title: "ICA — Internal Carotid Artery",
      col: C.orange,
      items: [
        "Amaurosis fugax: ipsilateral transient monocular blindness",
        "Combines MCA + ACA territory deficits",
        "Carotid bruit (tight stenosis)",
        "Horner's syndrome (cervical dissection)",
        "Massive hemisphere infarct if circle of Willis incompetent"
      ]
    },
    {
      title: "PCA — Posterior Cerebral Artery (P2 Cortical)",
      col: C.purple,
      items: [
        "Homonymous hemianopia (macular sparing)",
        "Bilateral → cortical blindness; may deny blindness (Anton's)",
        "Alexia without agraphia (dominant hemisphere)",
        "Prosopagnosia (face recognition loss)",
        "Memory impairment (hippocampal involvement)"
      ]
    },
  ];

  sections.forEach((sec, i) => {
    const by = 0.78 + i * 2.15;
    card(s, 0.28, by, W - 0.56, 2.05, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: 0.28, y: by, w: W - 0.56, h: 0.32, fill: { color: sec.col }, line: { color: sec.col } });
    s.addText(sec.title, {
      x: 0.38, y: by, w: W - 0.7, h: 0.32,
      fontSize: 10.5, bold: true, color: C.white, fontFace: "Calibri", valign: "middle"
    });
    s.addText(sec.items.map(t => "• " + t).join("\n"), {
      x: 0.38, y: by + 0.34, w: W - 0.7, h: 1.65,
      fontSize: 9.5, color: C.darkgray, fontFace: "Calibri", valign: "top"
    });
  });

  bottomBar(s, 7, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 8 — POSTERIOR CIRCULATION
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.teal, "POSTERIOR CIRCULATION STROKES", "Vertebrobasilar System");

  const psecs = [
    {
      title: "PCA — P1 (Proximal) Syndrome",
      col: C.purple,
      items: [
        "Weber's: ipsilateral CN III palsy + contralateral hemiplegia",
        "Claude's: CN III palsy + contralateral ataxia",
        "Thalamic: memory loss, confusion, hypersomnia"
      ]
    },
    {
      title: "Basilar Artery — CRITICAL",
      col: C.crimson,
      items: [
        "Top-of-basilar: coma, bilateral motor/sensory deficits",
        "Locked-in syndrome: quadriplegia + intact consciousness",
        "Warning TIAs: diplopia, ataxia, perioral numbness, drop attacks"
      ]
    },
    {
      title: "Lateral Medullary — Wallenberg Syndrome (PICA)",
      col: C.teal,
      items: [
        "Ipsilateral: facial pain/numbness (CN V), Horner's, cerebellar ataxia, hoarseness/dysphagia (CN IX/X)",
        "Contralateral: pain & temperature loss (body) — hemisensory",
        "Vertigo, nystagmus, intractable hiccups"
      ]
    },
    {
      title: "Lacunar Syndromes",
      col: C.navy,
      items: [
        "Pure motor hemiplegia — posterior limb internal capsule",
        "Pure sensory stroke — VPL nucleus thalamus",
        "Ataxic hemiparesis — ipsilateral ataxia + leg weakness",
        "Clumsy hand–dysarthria — pons or genu internal capsule"
      ]
    },
  ];

  psecs.forEach((sec, i) => {
    const by = 0.78 + i * 1.65;
    card(s, 0.28, by, W - 0.56, 1.55, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: 0.28, y: by, w: 0.16, h: 1.55, fill: { color: sec.col }, line: { color: sec.col } });
    s.addText(sec.title, {
      x: 0.52, y: by + 0.02, w: W - 0.82, h: 0.32,
      fontSize: 10.5, bold: true, color: sec.col, fontFace: "Calibri", valign: "middle"
    });
    s.addText(sec.items.map(t => "• " + t).join("\n"), {
      x: 0.52, y: by + 0.34, w: W - 0.82, h: 1.15,
      fontSize: 9.2, color: C.darkgray, fontFace: "Calibri", valign: "top"
    });
  });

  bottomBar(s, 8, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 9 — INVESTIGATIONS & ACUTE MANAGEMENT
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.crimson, "INVESTIGATIONS & ACUTE Rx", "Time-Critical Decisions");

  // Timeline strip
  const times = [
    { t: "0", label: "Onset" },
    { t: "25m", label: "Door-to-CT" },
    { t: "60m", label: "Door-to-Needle" },
    { t: "4.5h", label: "tPA window" },
    { t: "24h", label: "EVT window" },
  ];
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 0.72, w: W - 0.6, h: 0.08, fill: { color: C.crimson }, line: { color: C.crimson } });
  times.forEach((t, i) => {
    const tx = 0.3 + (i / (times.length - 1)) * (W - 0.6);
    s.addShape(pres.shapes.OVAL, { x: tx - 0.15, y: 0.64, w: 0.3, h: 0.3, fill: { color: C.crimson }, line: { color: C.white, pt: 1 } });
    s.addText(t.t, { x: tx - 0.5, y: 0.93, w: 1.0, h: 0.22, fontSize: 8.5, bold: true, color: C.crimson, fontFace: "Calibri", align: "center" });
    s.addText(t.label, { x: tx - 0.5, y: 1.13, w: 1.0, h: 0.22, fontSize: 7.5, color: C.gray, fontFace: "Calibri", align: "center" });
  });

  // Investigations
  sectionLabel(s, 0.3, 1.42, W - 0.6, "IMMEDIATE INVESTIGATIONS", C.navy);
  const invItems = [
    ["NCCT Brain", "Exclude hemorrhage before thrombolysis — do NOT delay for MRI"],
    ["CT Angiography", "Large vessel occlusion? Carotid stenosis?"],
    ["CT Perfusion", "Penumbra (salvageable tissue) — guides EVT up to 24h"],
    ["ECG", "Atrial fibrillation, acute MI"],
    ["Blood tests", "Glucose, FBC, coag, U&E, troponin, lipid profile"],
    ["MRI DWI/PWI", "Gold standard — confirms TIA vs stroke, posterior fossa"],
  ];
  invItems.forEach(([title, detail], i) => {
    const ry = 1.76 + i * 0.48;
    card(s, 0.3, ry, W - 0.6, 0.44, i % 2 === 0 ? "EBF2FB" : C.white);
    s.addText(title + ":", { x: 0.42, y: ry, w: 1.8, h: 0.44, fontSize: 9.5, bold: true, color: C.steel, fontFace: "Calibri", valign: "middle" });
    s.addText(detail, { x: 2.22, y: ry, w: 5.1, h: 0.44, fontSize: 9.2, color: C.darkgray, fontFace: "Calibri", valign: "middle" });
  });

  sectionLabel(s, 0.3, 4.68, W - 0.6, "REPERFUSION THERAPY", C.crimson);
  s.addText([
    { text: "IV Alteplase (tPA): ", options: { bold: true, color: C.crimson } },
    { text: "0.9 mg/kg (max 90 mg). Window ≤4.5h. BP must be <185/110 mmHg.\n", options: { color: C.darkgray } },
    { text: "Endovascular Thrombectomy (EVT): ", options: { bold: true, color: C.navy } },
    { text: "Large vessel occlusion, up to 24h with perfusion imaging (DAWN / DEFUSE-3 trials).\n", options: { color: C.darkgray } },
    { text: "General care: ", options: { bold: true, color: C.teal } },
    { text: "O₂ only if SpO₂ <94%  |  Permissive HTN up to 220/120 (no tPA)  |  Avoid glucose >180  |  Antipyretics  |  DVT prophylaxis", options: { color: C.darkgray } },
  ], {
    x: 0.35, y: 5.0, w: W - 0.65, h: 2.08,
    fontSize: 9.8, fontFace: "Calibri", valign: "top"
  });

  bottomBar(s, 9, TOTAL);
}

// ════════════════════════════════════════════════════════════════════════
// SLIDE 10 — SECONDARY PREVENTION + SAVE THIS CARD CTA
// ════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  bg(s, C.offwhite);
  topBar(s, C.green, "SECONDARY PREVENTION", "Prevent the Next Stroke");

  const prevSecs = [
    {
      title: "Non-Cardioembolic — Antiplatelet",
      col: C.steel,
      text: "Aspirin 300 mg STAT → Dual antiplatelet (aspirin + clopidogrel) for 21 days (POINT/CHANCE trial) → then clopidogrel 75 mg monotherapy long-term"
    },
    {
      title: "Cardioembolic / AF — Anticoagulate",
      col: C.crimson,
      text: "DOAC (apixaban / rivaroxaban) preferred over warfarin. Start 4–14 days post-stroke (size-dependent). Target CHA₂DS₂-VASc ≥2"
    },
    {
      title: "Blood Pressure",
      col: C.navy,
      text: "Target <130/80 mmHg. ACE-i or ARB + thiazide preferred. Greatest modifiable risk reduction."
    },
    {
      title: "Lipids & Lifestyle",
      col: C.teal,
      text: "High-intensity statin (target LDL-C <1.8 mmol/L). Smoking cessation. Weight loss. Physical activity ≥150 min/week. Limit alcohol."
    },
    {
      title: "Carotid Revascularization",
      col: C.orange,
      text: "Carotid endarterectomy (CEA) for symptomatic stenosis 70–99%. CAS (stenting) for surgical high-risk patients. Do within 2 weeks of TIA/stroke."
    },
  ];

  prevSecs.forEach((sec, i) => {
    const by = 0.78 + i * 1.25;
    card(s, 0.28, by, W - 0.56, 1.16, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x: 0.28, y: by, w: W - 0.56, h: 0.26, fill: { color: sec.col }, line: { color: sec.col } });
    s.addText(sec.title, { x: 0.38, y: by, w: W - 0.7, h: 0.26, fontSize: 10, bold: true, color: C.white, fontFace: "Calibri", valign: "middle" });
    s.addText(sec.text, { x: 0.38, y: by + 0.28, w: W - 0.7, h: 0.82, fontSize: 9.5, color: C.darkgray, fontFace: "Calibri", valign: "top" });
  });

  // Prognosis bar at bottom
  s.addShape(pres.shapes.RECTANGLE, { x: 0.28, y: 7.06, w: W - 0.56, h: 0.22, fill: { color: C.navy }, line: { color: C.navy } });
  s.addText("Prognosis: ~⅓ full recovery  ·  ~⅓ moderate disability  ·  ~⅓ severe/death. Stroke Unit reduces mortality ~25%", {
    x: 0.38, y: 7.06, w: W - 0.7, h: 0.22,
    fontSize: 7.5, color: C.gold, fontFace: "Calibri", align: "center", valign: "middle"
  });

  bottomBar(s, 10, TOTAL);
}

// ── WRITE FILE ─────────────────────────────────────────────────────────────
const outPath = "/home/daytona/workspace/stroke-poster/Stroke_Instagram_Carousel.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("Instagram carousel saved:", outPath);
});

Running Command

cd /home/daytona/workspace/stroke-poster && node make_instagram.js 2>&1

Now convert to PDF:

Running Command

cp /home/daytona/workspace/stroke-poster/Stroke_Instagram_Carousel.pptx /tmp/insta_temp.pptx && libreoffice --headless --convert-to pdf --outdir /tmp/ /tmp/insta_temp.pptx 2>&1 && cp /tmp/insta_temp.pdf /home/daytona/workspace/stroke-poster/Stroke_Instagram_Carousel.pdf && ls -lh /home/daytona/workspace/stroke-poster/Stroke_Instagram_Carousel.pdf

Your Instagram carousel is ready — 10 square slides, each self-contained for mobile reading:

Stroke Instagram Carousel

Presentation · PPTX

Stroke Instagram Carousel

PDF Document · PDF

Carousel breakdown (10 slides):

#	Card	Color
1	Cover — Bold title + "Swipe to learn →"	Dark navy + crimson
2	Definition & Classification — 87% ischemic vs 13% hemorrhagic with % breakdown	Navy
3	FAST Recognition — Big F·A·S·T boxes + "1.9M neurons/min" stat	Crimson
4	Risk Factors + ABCD² Score — Emoji-labeled risks + scoring table	Steel blue
5	Cerebrovascular Anatomy — All 3 Harrison's diagrams (territories, MCA lateral, ACA/PCA medial)	Dark navy
6	MCA Syndromes — Complete, dominant, non-dominant, lacunar	Steel blue
7	ACA · PCA · ICA Syndromes	Navy
8	Posterior Circulation — Wallenberg, basilar, locked-in, lacunar	Teal
9	Investigations + Acute Management — Timeline strip + tPA/EVT details	Crimson
10	Secondary Prevention — Antiplatelets, anticoagulation, BP, statins, CEA	Green

Each slide has a progress dot indicator and slide counter at the bottom. To post: export each slide as a PNG/JPG from PowerPoint and upload as a carousel.

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